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Even though this article is meant for potential investors, it's still interesting and tells the story of one researcher at Merck who, since 1993 (!), believed integrase inhibitors would work and stuck to it despite many failed efforts and being told by her superiors to change her focus to other areas, such as CCR5 blockers. One of the reader's comments after the article mentions that Isentress is the most expensive HIV drug at $35./day@! I didn't know that.

The article ends by saying: Recently Merck researchers found potential HIV drug targets by scanning the human genome. And Hazuda thinks there may be other ways to attack the virus too. "We haven't run out of ideas," she says.

Merck's AIDS Triumph

Matthew Herper, 08.07.09, 06:00 AM EDT

It went where other drug companies feared to tread and got a big-selling HIV drug.

Fifteen years ago, at the height of the AIDS epidemic, Merck researcher Daria Hazuda started work on a new drug to block the HIV virus from infiltrating people's DNA.

The odds seemed grim. Merck executives at one point advised her to switch to an alternative approach being explored by rival Pfizer. And as new combinations of antiviral pill seemed to put the HIV virus in check, Hazuda herself wondered whether there was really a need for another AIDS drug. But she kept working, even as several attempts at creating the drug foundered in early tests.

I don't believe very much in conspiracy theories but I follow the logic of profit. Please correct me if wrong but in reading this article I feel that there's absolutely no interest in investing in a cure. Merck expects big profit from this drug and they will maybe improve further research in similar meds that we have to take forever. Nothing that will stop the disease. Even if small biotech companies or private organisations will find the magic pill to eradicate the infection they need a big company to distribute this product to warrant availability to everyone infected. Since they are very relaxed about the slow progress in this direction I guess no real breakthrough is to be expected in the next decade considering also the mega merge of the 2 other big pharma corporations Glaxo and Pfizer. What I see is the logic of market and nothing else. If they invest in HAART they don't feel the menace of something potent coming out from a competitor or smaller company. I'm probably wrong and I hope so. Please give me evidence that I missed the point and that the reality is different.

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I think the market drives innovation. If a competing company has something that is better than current ARVs (maybe a once day medication that has no resistance issues, say, or medication with no toxicity that's taken monthly, or even, dare I say it, a functional cure), they know this will compete with current ARVs and if it's better, it will make more money, hence they will want to develop it and bring it to market.

I think what you are saying, xman, makes sense if there was no competition. If there was one company that had a monopoly then they would want to maintain the status quo and reap the profits. But as long as there is competition, there will be innovation.

In fact, from that chart Isentress is even cheaper than Prezista or Aptivus when you factor in the required Norvir booster, though the difference is minimal with those last examples. I'd still say that Isentress is reasonably priced for a new medication, certainly when it is the first in its class.

I think what you are saying, xman, makes sense if there was no competition. If there was one company that had a monopoly then they would want to maintain the status quo and reap the profits. But as long as there is competition, there will be innovation.

yes but the issue is that only a giant can compete with another giant. i don't believe that a small biocompany without the financial possibilities of a corporation is able to compete. even if they find something potent they need a partner to distribute it. aren't you concerned about the lack in investments by the big companies in a theurapeutic vaccine? why 2 companies merge to create one big developer of new haart medicines that are clones of the current ones? if there would be even a small possibility of something revolutionary coming out they wouldn't spend millions to create a new company. remember that the breakthrough of haart came from big pharma and not from a small company, university or an isolated group of scientists. i think there's a precise logic behind this. why finding a cure if the current meds works so well, both on the clinical level than on sales?

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In fact, from that chart Isentress is even cheaper than Prezista or Aptivus when you factor in the required Norvir booster, though the difference is minimal with those last examples. I'd still say that Isentress is reasonably priced for a new medication, certainly when it is the first in its class.

Yes, that's a good point, the fact that it doesn't need the Norvir booster.

I'm really hoping that extended studies determine that unboosted Reyataz and Isentress work well together (alas, probably not with everyone but with some people) because I'm not thrilled with NRTIs, even though Truvada is not as bad as others, yada yada.

Even though it's tricky since they both have low barriers to resistance, it would be 2 good drugs, both very decent when it comes to toxicities.......duo therapy, woo hoo.

"I have tried hard--but life is difficult, and I am a very useless person. I can hardly be said to have an independent existence. I was just a screw or a cog in the great machine I called life, and when I dropped out of it I found I was of no use anywhere else."